Provider Demographics
NPI:1184598237
Name:EVERGREEN CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:EVERGREEN CHIROPRACTIC CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MERIDTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-964-1325
Mailing Address - Street 1:1570 WILMINGTON DR STE 120
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8773
Mailing Address - Country:US
Mailing Address - Phone:235-964-1325
Mailing Address - Fax:253-964-1329
Practice Address - Street 1:1570 WILMINGTON DR STE 120
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-8773
Practice Address - Country:US
Practice Address - Phone:235-964-1325
Practice Address - Fax:253-964-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty